Preoperative Clinic:

Instructions for Referring Adult Patients to the Anesthesia Preoperative Clinic

• Consultant Physician Preoperative Assessment Form

General Information for UMHS Surgery Clinics

Adult patients scheduled for ADP or OP surgery may require an appointment in the  Anesthesia Preoperative Assessment Clinic. This preoperative visit provides an anesthesia evaluation, preoperative instructions, and an opportunity for patients to address their anesthesia concerns. The preoperative visit takes approximately 20 minutes to an hour depending upon:

• The complexity of the patient

• Evaluation done by the surgical service

• How busy the clinic is at that particular time

Appointments

Preop Anesthesia is NOT a walk-in clinic. ALL PATIENTS MUST HAVE A SCHEDULED APPOINTMENT.

Please schedule and cancel ALL appointments through EWS. Appointments that are scheduled (or canceled) within 48 hours of the appointment date must be done by calling the Preop Clinic directly. Advance notice is necessary to allow adequate time for appropriate insurance referral/authorization.

Clinic hours are 8:30 am to 5:00 pm Monday through Thursday. Appointments are schedule from 9:00 am to 4:00 pm Monday through Thursday. Fridays clinic hours vary; the EWS grid reflects Friday hours. The last scheduled appointment Monday through Thursday is 4:00 pm. This is to allow time for the accessibility of additional services if required by the patients. In addition, this allows time to contact the surgical staff while still available with any questions and/or problems.

Preop Anesthesia appointments are scheduled on the 1/2 hour (ie: 9:00 am, 9:30 am, 10:00 am, etc.) Please schedule only 3 patients per time slot. Any appointments needing to be "over-booked" MUST be arranged by the Preop Anesthesia Clinic. DO NOT overbook appointments in EWS Preop Anesthesia Scheduling Grid.

Please notify the Preoperative Anesthesia Clinic at 936-3604 if a patient is not coming or has been canceled.

Some days the clinic may be fully booked. The clinic will attempt to accommodate patients, especially those who are from a long distance and not returning before their surgery date.

Requirements

• A scheduled appointment (see above)

• Patients with managed care insurance will need the appropriate insurance referral/authorization prior to the scheduled visit. Preop Anesthesia bills for an outpatient consult. Without the appropriate insurance referral/authorization, the patient will be billed for the visit.

• The patient’s hospital chart, which includes an H & P and signed surgical consent form.

• Tests deemed necessary by the surgical service (EKG, CXR, cardiology consults, etc.) should be completed prior to the Preoperative Clinic visit, this allows for a more meaningful and timely evaluation.

Patients Who DO Require a Preoperative Anesthesia Clinic Visit

• Patients with mild chronic medical problems (not functionally debilitating, ASA Class II) may need a preoperative visit if there is a question whether the condition is optimized or not.

• Patients with significant medical disease (functionally debilitating, generally ASA Class III Patients) requires a Preoperative Anesthesia Evaluation.

Patients Who DO NOT Require a Preoperative Anesthesia Clinic Visit

• Healthy patients without chronic medical problems (ASA Class I) generally do not need a preoperative visit.

• Patients with chronic medical conditions under optimal medical control (ASA Class II) may not need a preoperative visit.

• Patients who have had a Preoperative Anesthesia evaluation with surgery rescheduled for a later date may be updated on the morning of the surgery unless a significant change in their physical status has occurred in the interim. Likewise, patients who require multiple surgeries, but have an unchanging general physical status, do not need repeat visits to the Preoperative Clinic.

Inpatient Consults

Inpatient consults are scheduled through the Main Operating Room Anesthesia Clerk – Phone 6-4270. If you have any questions or concerns, please feel free to contact me at 926-4280 or e-mail pbenedic@med.umich.edu .

Dept. of Anesthesiology, Univ. of Michigan Medical School

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